Fqhc network account manager

• Serve as plan liaison for physicians/physician groups in a specified geographical area
• Will be the main point of contact for all plan related issues including marketing, enrollment, contracting, billing and reimbursement
• Responsible for the resolution of all issues, including those identified by the provider, and those identified internally that have an impact on the physician
• Coordinates with all Healthfirst staff to assist as appropriate, including creating project plans, issue logs, conference calls, etc
• Responsible for the provider recruitment process
• Schedule frequent and regular face-to-face contact with the practice locations to identify any issues and ensure plan visibility
• Keep abreast of competitor activity, including new reimbursement and marketing strategies
• Negotiate favorable/competitive rates with providers based on market trends
• Conduct new provider orientation and identify opportunities for education on both clinical and administrative topics
• Responsible for monitoring and reporting on providers' clinical quality & financial performance, working with their manager and other internal departments to create strategic improvement plans
• Working under light supervision, maneuvers multiple tasks independently with a fast paced proactive vs. reactive approach to changing priorities while meeting departmental objectives
• Contribute creative solutions and ownership of daily assignments for seamless communication and systematic completion of routine and special projects
• Handle other duties as assigned with the occasional need to work weekends, overtime and/or travel throughout the tristate area
• Engage in mastering the Division's impact on Healthfirst, its Members, and Providers

• HSD/GED
• Medicare and/or Medicaid managed care experience
• Excellent oral and written communication skills (Letter writing, Memo, and Email)

• Bachelor’s Degree from an accredited institution
• Active driver license and access to a vehicle
• Provider office operations experience
• Ability to understand Provider claims reimbursement
• Contract negotiation experience
• Bilingual fluency (reading, writing, speaking) Chinese or Spanish and English
• Exposure to multiple functions especially finance, business intelligence
• Experience with Microsoft office such as Excel, Outlook, and/or electronic archiving

medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions